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MIPS Year 3 (2019) Final
MIPS Determination Period
Low Volume Threshold Determination Period:
• First 12-month segment: Sept. 1, 2016 - Aug. 31, 2017
(including 30-day claims run out)
• Second 12-month segment: Sept. 1, 2017 - Aug. 31,
2018 (including a 30-day claims run out)
Special Status
• Use various determination periods to identify MIPS
eligible clinicians with a special status and apply the
designation.
• Special status includes:
– Non-Patient Facing
– Small Practice
– Rural Practice
– Health Professional Shortage Area (HPSA)
– Hospital-based
– Ambulatory Surgical Center-based (ASC-based)
Year 2 (2018) Final
Change to the MIPS Determination Period:
• First 12-month segment: Oct. 1, 2017 - Sept. 30,
2018 (including a 30-day claims run out)
• Second 12-month segment: Oct. 1, 2018 - Sept. 30,
2019 (does not include a 30-day claims run out)
• Goal: Consolidate the multiple timeframes and align
the determination period with the fiscal year
• Goal: Streamlined period will also identify MIPS
eligible clinicians with the following special status:
-
Non-Patient Facing
-
Small Practice
-
Hospital-based
-
ASC-based
Note: Rural and HPSA status continue to apply in 2019
Year 3 (2019) Final
Quick Tip: MIPS eligible clinicians with a special status are included in MIPS and qualify for special rules. Having a special status does
not exempt a clinician from MIPS.